YOUR MOVE

Words: Matt Daugherty

Hello

FTR Family,

Happy off-season! I hope you took my advice from last month and temporarily avoided the repetitive impact and joint loading that riding creates, even for a little while. If that is the case, you probably feel your best since the last offseason. Your everyday racing season aches and pains are less severe, and those nagging ailments are being addressed so they don’t bother you next season. What’s that, you say? You are more sore than ever? Well, that was probably from racing the 24 hours of Perry Mountain, a brutal endurance race. Talk about not taking your PT’s advice! But seriously, we had a strong FTR showing and had some trophies won at the Perry Mountain 24 race, congratulations to those of you that raced.

Let’s talk a little more about underlying impairments. An underlying impairment is a causative factor in your musculoskeletal system, leading to other issues. Sometimes the underlying impairment is not clinically significant enough to cause symptoms, but it stresses and loads other tissues in your body that become symptomatic. One of my mentors used to say,

“Tendonitis is the result, not the root cause of the problem.” She means there is often an underlying problem, such as a mobility deficit at a joint, which causes the muscle and tendon that cross that joint to be abnormally loaded. Once the muscle or tendon is abnormally loaded long enough, it becomes inflamed or painful.

In this situation, if you directly treat the tendonitis, you will get relief, but usually, the comfort is short-lived, or the tendonitis comes back and tends to linger. Many of us can identify with musculoskeletal pain issues that repeatedly return despite treating them. This lack of accurate diagnosis of the underlying impairment is one of the risks of consulting the internet (i.e., Google, WebMD, etc.) for your symptoms rather than a trained medical professional. But if you find the causative factor, you can unlock the healing process and prevent future occurrences of that issue. The key is prevention rather than rehabilitation. It’s better to go through a set of tests and measures to find underlying problems rather than to treat them once they rear their head as resultant issues. I am happy to help you with this process.

Tomac’s season-ending Supercross injury might be an example of an underlying impairment. I am not convinced the degree of ankle dorsiflexion load he sustained with that minor overjump was enough to rupture his Achilles tendon if it was healthy. Although it is the most significant type of load on the tendon, it occurs repetitively every time we jump and land while standing on the balls of our feet. Any professional rider has loaded their Achilles in this way countless times without issue. Also, consider the Achilles tendon the strongest tendon in the human body. Forward-thinking orthopedic surgeons are currently using it for ACL reconstructions.

Tomac’s Achilles rupture seems to follow the pattern of high-level athletes that rupture their Achilles with a relatively minor incident. Look up David Beckham or Kevin Durant’s Achilles rupture videos, and you will see the same mechanical mechanism of injury. A normal tendon load for their sport was placed on their Achilles and caused it to rupture. Yes, I know there is much controversy with Tomac’s injury regarding foot pegs and boots he was wearing/how he was wearing them. I’m still not convinced that there was not an underlying pathology in his left Achilles or an underlying impairment. A few simple tests and measures can screen out these underlying impairments and prevent catastrophic failure of the tissue. At the very least, if you know the underlying impairment, you can manage it better with more accurate information.

Before acting on any information in this article, I highly recommend that you consult a physical therapist or physician for a general health and physical activity readiness screening. If you are experiencing pain while riding, it is always beneficial to have a complete evaluation by a physical therapist or physician.

If you have any questions or comments, please email me at contact@motopt.com, or call 904-395-5379.

Let’s IMPROVE YOUR MOVE so you can ride pain-free with MotoPT.

Dr. Matthew Daugherty PT, DPT, OTR/L, MOT, DBA Associate Professor

Board-Certified Orthopaedic Clinical Specialist

Fellow, American Academy of Orthopaedic Manual Physical Therapists

Manual Therapy Certified